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Randomized Controlled Trial
. 2015 Jul;123(1):18-28.
doi: 10.1097/ALN.0000000000000704.

Decision Aid for Cigarette Smokers Scheduled for Elective Surgery

David O Warner  1 , Annie LeBlanc, Sandeep Kadimpati, Kristin S Vickers, Yu Shi, Victor M Montori
Affiliations
Randomized Controlled Trial

Decision Aid for Cigarette Smokers Scheduled for Elective Surgery

David O Warner et al. Anesthesiology. 2015 Jul.

Abstract

Background: Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery.

Methods: In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care.

Results: The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including two to three pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (P < 0.05) improved measures of decisional quality and patient involvement in decision making (Cohen's d effect sizes of 0.76 and 1.20 for the Decisional Conflict Scale and Observing PatienT involvement In decisiON-making scale, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices.

Conclusions: Although the use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior.

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Conflict of interest statement

Conflicts of Interest: None declared

Figures

Figure 1
Figure 1
Decision aid. A: Sleeve containing the three cards; B: Front and back of the “Continue to smoke” decision aid card; C, Front and back of the “Quit for good” decision aid card; D. Front and back of the “Quit for a bit” decision aid card.
Figure 2
Figure 2
Study flow diagram
See this image and copyright information in PMC

Comment in

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